NCQA Certified Credentials Verification Services

Our services include efficient data management for tracking and updating provider credentialing information. We are able to provide continuous reporting to our client organizations. Our clients can trust that practitioner’s data is maintained in a completely secure credentialing system. Above all, AQC strives to meet or exceed the unique requirements of all of its client organizations. We believe in partnering with you in order to ensure your organization is able to consistently comply with the standards and regulations governing your credentialing procedures, as well as with the rules and regulations of your organization.

Examples of Initial Application and Primary Source Verifications for Healthcare and Insurance Providers

  • Current and Prior State Professional Licensure
  • Board Certification
  • National Practitioner Data Bank (NPDB)
  • Education
  • Training (Internship, Residences, Fellowships)
  • DEA/CDS Certification
  • OIG Check for Medicare/Medicaid Sanctions (this can also be ongoing)
  • Malpractice Coverage and Claims History
  • Hospital Affiliations (past and current)
  • Academic & Faculty Appointments
  • Professional References
  • Work History
  • Licensure tracking and monitoring

Examples of Re-credentialing Application and Primary Source Verification for Healthcare & Insurance Providers

Every two or three years as required

  • Current and Prior State Professional Licensure
  • American Board of Medical Specialties
  • National Practitioner Data Bank
  • Board Certification
  • Additional Training (Internship, Residences, Fellowships, if applicable)
  • DEA/CDS Certification
  • OIG Check for Medicare/Medicaid Sanctions
  • Malpractice Coverage and Claims History
  • Hospital Affiliations (past and current)
  • Academic & Faculty Appointments
  • Professional References

We are able to mail, fax or email forms directly to the provider for review and signature. Depending on the services we are contracted to provide to your organization, we will ensure that the provider application package is securely sent to the recipient you have directed us to send the information to, or we will immediately begin the process of primary source verification on your behalf, or we will return the completed application package to you if requested. Your online access allows clients to monitor the entire process.

Update Reports

As a part of our standard service, we send status reports to you throughout the process so you are continuously updated and informed about the credentialing status of your providers. Customized and timely.

RUSH Verifications and Application Processing

AQC offers expedited credentialing, primary source verification and application management services as well. This level of service can be critical to organizations needing to ensure the completion of work in less than the normal time or as agreed upon between your organization and the CVO.

Provider Data Management, Monthly, Quarterly or Yearly Credentials Tracking & Document Storage

Our unique credentialing system gives us the ability to track the expiration of important provider credentials such as licensure, DEA registration(s), Board certification, malpractice insurance, etc. In addition to tracking this critical information, we also have the ability to store current and history documents in our database. Because our database is accessible by the manager also, the PSV process is no longer done in secret.

Ongoing Monitoring

Our system gives us the ability to monitor and provide reports relating to licensure status changes, disciplinary and other actions that are taken by licensing boards and/or OIG. When we know that any actions have been taken against a provider that affect licensure or the practitioner’s ability to participate in Medicare or Medicaid, we will notify you immediately.

Custom Reporting

We will work with you to create any customized reports you may need to track the status of verifications and provider enrollment activities.

Fast Track Credentialing/Re-credentialing

AQC’s service is designed to assist organizations with verifications and application management during peak times of the year when a high volume of new credentialing or recredentialing is anticipated. We are available PRN.

"A la Carte" Verifications

A significant discount is available for clients who may not want to include all primary source verification services provided by Advanced Quality Compliance & CVO due to cost containment or other reasons. For these clients, there is an option to select certain verifications from a “menu” provided by the AQC.

Web Access

Our ground-breaking data base includes the ability for our clients to access their practitioner’s credentialing information via the Internet. With a link to the database via the Internet, our clients will have an up to the minute status for all practitioners.

AQC is dedicated to keeping medical organizations in full compliance with standards, laws, and effective teamwork.